Multiple Intracranial Tuberculomas Mimicking Granulocytic Sarcomas in Acute Myeloid Leukemia.
10.3346/jkms.2007.22.S.S171
- Author:
Jae Sook AHN
1
;
Duk Hwan YANG
;
Yoe Kyeoung KIM
;
Sang Hee CHO
;
In Young KIM
;
Je Jung LEE
;
Ik Joo CHUNG
;
Hyeoung Joon KIM
Author Information
1. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. hjoonk@chonnam.ac.kr
- Publication Type:Case Report
- Keywords:
Acute Myelogenous Leukemia;
Intracranial Tuberculoma;
Immunocompromised Patient
- MeSH:
Antitubercular Agents/therapeutic use;
Brain Neoplasms/*diagnosis;
Diagnosis, Differential;
Humans;
Leukemia, Myeloid, Acute/*complications;
Magnetic Resonance Imaging;
Male;
Middle Aged;
Sarcoma, Myeloid/*diagnosis;
Tuberculoma, Intracranial/complications/*diagnosis/drug therapy
- From:Journal of Korean Medical Science
2007;22(Suppl):S171-S173
- CountryRepublic of Korea
- Language:English
-
Abstract:
The diagnosis of incracranial tuberculoma in immune-compromised hosts is often difficult because conventional magnetic resonance (MR) imaging of tuberculoma reveals various findings and neurologic symptoms are not typical. Here, we report a case of a 54-yr old man with multiple intracranial tuberculoma who was treated for acute myeloid leukemia. He complained of right-side paresthesia after the third consolidation chemotherapy without leukemic relapse and fever. MR imaging of the brain showed multiple ring-enhanced lesions in the cerebrum, cerebellar hemisphere, and pons. The lesions appeared to mimic a metastatic tumor or abscess. Cerebrospinal fluid analysis showed no abnormal cells, but the level of adenosine deaminase was elevated (28.8 IU/L, normal 0-8). Stereotactic brain biopsy was performed, but only reactive gliosis was observed. To confirm diagnosis, an open brain biopsy was performed. The histopathology demonstrated chronic granulomatous inflammation with caseous necrosis. Tuberculous-polymerase chain reaction of the biopsy showed a positive result. He was treated with anti-tuberculosis medication and a high dose of steroid. Paresthesia improved, and follow-up brain MR imaging showed the decreased size and numbers of ring-enhanced lesions and improvement of perilesional edema 1 month after treatment. Here, we report on an interesting case of intracranial tuberculoma in acute myeloid leukemia.
